Mphumu ya bronchial ndi matenda osokoneza bongo amachitika motsutsana ndi maziko a kulakwitsa kwa chitetezo chathupi. Matenda a shuga amayamba ngati matenda a autoimmune ndikupanga ma antibodies kupita ku ma cell pancreatic ake. Pa mphumu ya bronchial, mungu mungu, chakudya, tsitsi la nyama, ndi mabakiteriya amachita ngati antigen.
Pophunzira za ubale pakati pa matenda amenewa, zidapezeka kuti chilengedwe chimakhudza kukhazikika kwa mitundu iwiri ya matenda ashuga komanso matenda amphumo a bronchial. Chiwopsezo cha mphumu cha matenda ashuga chimakhala chachikulu kuposa mwa anthu opanda matenda a autoimmune.
Palinso chiopsezo cha kufooka kwa kagayidwe kazakudya kwa asthmatics omwe amagwiritsa ntchito glucocorticosteroids pochizira. Ndi kuphatikiza uku, shuga, monga zovuta za steroid mankhwala, sizachilendo kuposa mafupa kapena zovuta zina, koma ma steroids onse ndi beta-receptor amapititsa patsogolo maphunziro a shuga omwe alipo.
Zimayambitsa chitukuko ndi zizindikiro za matenda ashuga
Chimodzi mwazomwe zimayambitsa matenda ashuga, makamaka mtundu woyamba, ndizotengera zam'tsogolo, kupezeka kwa shuga kwa makolo kumawonjezera mwayi wokhala ndi mwana wopitilira 40 peresenti.
Kwa mtundu wa 1 shuga mellitus, palinso kulumikizana ndi matenda akale opatsirana kapena autoimmune. Matenda a shuga amatha kukhala chovuta cha chotupa cha khansa ya kapamba kapena chotupa.
Kupsinjika kwa Psychoemotional, komanso matenda a endocrine system - chithokomiro cha chithokomiro, tiziwalo timene timatulutsa timadzi tambiri kapena timene timapangitsa kuti timadzi tambiri tiziwonongeka mthupi.
Mtundu 2 wa shuga wosadalira insulini nthawi zambiri umayamba pazifukwa izi:
- Mwa anthu pambuyo pa zaka 45
- Ndi onenepa kwambiri, makamaka m'mimba mtundu wa kunenepa kwambiri.
- Atherosclerosis, cholesterol yayikulu ndi dyslipidemia.
- Matenda oopsa.
- Kumwa mankhwala - mahomoni, beta-blockers, thiazide diuretics.
Pozindikira mtundu 1 wodwala matenda am'mimba, zizindikilo zambiri zimawerengedwa: kufooka, kukodza pokodza, kuchuluka kwamkodzo kwamkati usiku, kuwonda. Kuchulukitsa kukopa kumadziwika. Odwala amamva ludzu pafupipafupi komanso pakamwa lowuma, lomwe silimatha madzi akumwa.
Mantha nthawi zonse, kusintha kwa kusinthasintha, komanso kukwiya, komanso kutopa ndi matenda a shuga. Amawonetsa kuchepa kwa glucose m'maselo aubongo, monga gawo lovuta kwambiri pakusowa kwa chakudya.
Kuchuluka kwa glucose m'magazi kumayambitsa kuyabwa kwa khungu ndikusokonekera kwa zimagwira mucous, kuphatikiza pa perineum. Kuphatikizidwa kwa matenda oyamba ndi fungus m'njira ya candidiasis kumathandizira chizindikiro ichi.
Kuphatikiza apo, odwala matenda a shuga amadandaula za dzanzi kapena kuyabwa kwa mapazi ndi manja, totupa pakhungu, furunculosis, kupweteka kwa mtima komanso kusinthasintha kwa magazi.
Ngati zizindikirazo zimachitika mwadzidzidzi ndipo zimatha, ndiye kuti matendawa amatha kuchedwa - panthawi yopanga zovuta (ketoacidosis).
Odwala omwe ali ndi shuga wambiri, nseru, kusanza komanso kupweteka kwam'mimba kumawonjezera, kununkhira kwa acetone kumawonekera mu mpweya wotopa, ndi ketoacidosis yayikulu, chikumbumtima chimalephera, wodwalayo amagwa chikomokere, limodzi ndi kukomoka komanso kuchepa thupi magazi.
Kuti muwonetsetse ngati mukudwala matenda ashuga, kuyezetsa magazi kwathamanga kumachitika - ndimatenda a shuga, glucose ndi okwera kuposa 6.1 mmol / l, mukamagwiritsa ntchito mayeso ololera a glucose maola 2 mutatha kuchita masewera olimbitsa thupi, amaposa 7.8 mmol / l. Kuphatikiza pa izi, ma antibodies enieni, glycated hemoglobin, amayesedwa.
Mikhalidwe ndi zizindikiro za mphumu ya bronchial
Mphumu ya bronchial imachitika ndi kuphipha kwa thirakiti la kupuma mothandizidwa ndi ena akhungu. Imakhala ndi chibadwa chomwe chimapangitsa kukula mwa chikhalidwe chamtundu wamtundu wamatumbo kuti asokoneze matupi awo.
Imatha kupsa mtima chifukwa cha kusuta, kuzindikira chidwi cha bronchi poipitsa mpweya ndi fumbi, mipweya yotulutsa mpweya, komanso zotayira zonyamula mafakitale. Mpweya wa mphumu umakonda kupezeka pambuyo pa matenda a bacteria kapena bacteria, hypothermia, kulimbitsa thupi kwambiri, komanso kuvulala pachifuwa.
Chizindikiro chofanana cha mphumu ndi chifuwa chokhala ndi vuto la mphumu, kupuma movutikira, kumenya likhweru ndi kugudubuza kwa bronchi.
Pa mphumu ya bronchial, zizindikiritso zofunika ndiz:
- Matenda am'banja (mphumu, dermatitis ya atopic, hay fever, rhinitis).
- Kupezeka kwa ziwengo pambuyo polumikizana ndi zomera kapena nyama, ndi matenda opuma.
- Kudwala chifuwa ndi mphumu kumakulirakulirakulira usiku, mutatha kulimbitsa thupi, kusintha kwanyengo.
Mphumu ya bronchial mu shuga imachitika nthawi zambiri ndi mtundu woyamba, wodalira insulini. Panalibe kuyanjana pakati pa matenda ashuga amtundu wa 2 komanso zochitika za mphumu.
Mpweya wa Steroid-Resistant ndi shuga
Odwala omwe ali ndi mphumu omwe ali ndi matenda a shuga, njira ya mphumu nthawi zambiri imakhala yolimba, ndicho chifukwa choikidwiratu a acidic acid. Kugwiritsa ntchito mankhwala okwera kapena kwa nthawi yayitali kumabweretsa kunenepa kwambiri. Kuonjezera thupi kungayambitse ziphuphu usiku kapena kuvuta kutsokomola. Kunenepa kwambiri kumachulukitsanso mawonetseredwe a shuga.
Odwala ambiri omwe ali ndi mphumu ya bronchial, amatha kuthetsa kukomoka ndi kupuma kwa glucocorticosteroids. Mwa odwala ena, izi sizimapereka kufunika kwa mawonekedwe a kukula kwa bronchi, ngakhale mutagwiritsa ntchito ma steroid mkati kapena mawonekedwe a jakisoni.
Odwala oterewa amadziwika kuti ndi antiid. Kukana kwa Steroid kumawerengedwa ngati kutsimikizika kwakunyamuka mu 1 s (monga kuyerekezera ndi spirometry) - FEV 1 siyikuwonjezeka kuposa 15% pakumapuma kwa betamimetic mutatenga 40 mg ya prednisolone patsiku kwa sabata limodzi.
Pozindikira matenda amphumo a steroid, ziyeso zotsatirazi ziyenera:
- Kuwerenga kwa ntchito yam'mapapo ndi index ya Tiffno.
- Khazikitsani cholozera cha bronchial pambuyo pa 200 mcg ya salbutamol.
- Chitani kafukufuku wa histamine.
- Ndi bronchoscopy, onani kuchuluka kwa ma eosinophils, cytology ndi biopsy ya bronchi.
- Pambuyo pa masabata awiri mutatenga Prednisolone, bwerezani mayeso azidziwitso.
Kusintha kumeneku kwa matenda a mphumu ya bronchial kumadziwika ndi kuukira pafupipafupi komanso kowopsa komwe kumafuna kuti agonekere kuchipatala, kuphatikiza m'malo opulumutsa kwambiri, kuchepa kwa moyo.
Chifukwa chake, kuphatikiza pakumapuma kwa ma steroid, odwala oterewa amagwiritsidwa ntchito pakamwa kapena jakisoni. Chithandizo chotere chimayambitsa matenda a shuga a Itenko-Cushing komanso matenda a shuga. Nthawi zambiri, azimayi azaka zapakati pa 18 ndi 30 amadwala.
Mbali zakuchiritsa mphumu ku matenda ashuga
Vuto lalikulu la kuchiza matenda amphumu m'matenda a shuga ndi kugwiritsa ntchito mankhwala omwe ali ndi vuto linalake, chifukwa beta-receptor yotupa mu bronchi ndi systemic corticosteroids imakulitsa shuga.
Glucocorticosteroids imakulitsa kuchepa kwa glycogen komanso kupanga glucose mu chiwindi, betamimetics imachepetsa chidwi cha insulin. Salbutamol, kuwonjezera pakukula kwa shuga wamagazi, imawonjezera chiopsezo cha zovuta monga matenda ashuga a ketoacidosis. Kuchiza kwa Terbutaline kumakweza shuga mwakulimbikitsa kupanga glucagon, womwe ndi wotsutsana ndi insulin.
Odwala omwe amatenga zotsatsira za beta monga ma inhalation sakhala ndi vuto la hypoglycemia kuposa omwe amagwiritsa ntchito mankhwala a steroid. Ndiosavuta kwa iwo kukhala ndi shuga wokhazikika m'magazi.
Chithandizo ndi kupewa zovuta za mphumu ndi matenda a shuga zimakhazikitsidwa motengera mfundo izi:
- Kuwonedwa ndi endocrinologist ndi pulmonologist, chifuwa.
- Zakudya zoyenera komanso kupewa kunenepa kwambiri.
- Kusungabe zolimbitsa thupi.
- Kuwongolera kwambiri kwa shuga m'magazi mukamagwiritsa ntchito ma steroid.
Kwa odwala omwe ali ndi mphumu ya bronchial, kusiya kusuta kwathunthu ndikofunikira, popeza izi zimayambitsa pafupipafupi kukwiya ndikuyambitsa kusokonezeka kwa magazi, vasospasm. Mu shuga mellitus, mu nyengo ya angiopathy, kusuta kumawonjezera mwayi wokhala ndi matenda a shuga, matenda amtima, chiwonongeko cha impso komanso kulephera kwa aimpso.
Poika glucocorticosteroids mapiritsi okhala ndi mapangidwe a matenda a shuga ndi mphumu ya bronchial, payenera kukhala ndizowonetsa. Izi zimaphatikizapo kugwidwa kwa mphumu pafupipafupi komanso kosalamulirika, kusowa kwa mphamvu kuchokera kugwiritsidwa ntchito kwa ma steroid pakupuma.
Kwa odwala omwe adalembedwa kale kukonzekera kwa glucocorticoid m'mapiritsi kapena amafuna kuchuluka kwa mahomoni, Prednisolone imawonetsedwa osaposa masiku khumi. Kuwerengera mlingo kumachitika pa kilogalamu ya kulemera kwa thupi patsiku, osaposa 1-2 mg pa kg.
Chifukwa chofala kwambiri chachitukuko cha matenda a shuga a steroid ndi zovuta za matenda omwe alipo ndikuwikidwa kwa mankhwala a steroid omwe amatha kupanga depot m'thupi. Mankhwalawa amachepetsa magwiridwe amtundu wa adrenal; sangathe kutumikiridwa munthawi yochepa. Mankhwalawa ndi monga: Dexamethasone, Polcortolone ndi Kenalog.
Ubwino wakugwiritsa ntchito mphumu ndi matenda a shuga ndi:
- Chidakwa chophatikizika bwino kwambiri chomwe chili ndi ma steroid ndi Budesonide. Itha kugwiritsidwa ntchito mwa ana ndi akulu, komanso kwa amayi apakati.
- Pulmicort mwanjira ya nebul ikhoza kugwiritsidwa ntchito kuyambira chaka chimodzi, yogwiritsidwa ntchito kwa nthawi yayitali, yomwe imakulolani kukana mapiritsi a Prednisolone. Ufa wowuma mu turbuhaler amalembedwa kuchokera zaka 6.
- Kuchiza ndi fluticasone propionate mu nebulas kumatha kutenga mawonekedwe a monotherapy ndipo sikutanthauza kupatsidwa mankhwala ena mwatsatanetsatane.
Mukamawerengera mphamvu yamagetsi amtundu wa ultraviolet popewa kukula kwa matenda omwe ali ndi vuto la chitetezo cha mthupi, zidapezeka kuti kupangidwa kwa vitamini D pakhungu kumachepetsa chiopsezo cha matenda a shuga. Chifukwa chake, ana osakwana chaka chimodzi omwe amamwa vitamini A woletsa kuphatikiza ma ricores sakhala akudziwika kuti ali ndi matenda ashuga.
Vitamini D akuwonetsedwa kwa odwala onse omwe amatenga prednisolone kuti apewe matenda a mafupa, omwe nthawi zambiri amakhala zotsatira zoyipa za steroids.
Pofuna kupewa zovuta za matenda ashuga matenda a mphumu, odwala amalangizidwa kuti azitsatira zakudya zomwe zimaletsedwa pang'ono ndi zakudya zomwe zingayambitse thupi.
Kuwunika pafupipafupi kuchuluka kwa kagayidwe kazakudya komanso kusintha kwa mankhwalawa pakapangidwe ka glucocorticoids ndikofunikira. Ndikofunika kugwiritsa ntchito njira ya inhalation yoyendetsera, ndipo ngati kuli kotheka, chitani chithandizo cha mankhwala a prenisolone mwachidule. Kuti muwonjezere zolimbitsa thupi, zolimbitsa thupi zolimbitsa thupi ndi masewera olimbitsa thupi polimbikitsidwa ndi shuga. Vidiyo yomwe yatchulidwa m'nkhaniyi idzafotokoza chifukwa chake mphumu ndiopsa ku matenda ashuga.
